Clearinghouse Services Status

Last updated: 4/29/24 at 10:40 AM ET

A cyberattack against Change Healthcare caused all clearinghouse services to be shut down on 2/21/24. TherapyNotes has migrated claims and ERA features to CLAIM.MD, and we now support enrollments. Eligibility requests and a paper claim mailing service are currently unavailable but we are working to reintroduce this functionality as well. We are also continuing to deal with a number of odds and ends. This page will maintain the status of all current issues and updates, plus cover some FAQs.

Can I send Claims now for payers that don't require enrollment?

Status: Yes. TherapyNotes can now send electronic claims to any payer supported by CLAIM.MD. (4/24) 

Can I send claims to payers that require enrollment? Why are my claims stuck as “Pending”? And what is enrollment anyway?

Some payers require you to complete paperwork in order to send claims from a new clearinghouse. This is separate from ERA enrollment, which is required by all payers because that's how you tell them where to send your ERA files. Do not confuse enrollment with credentialing. Credentialing with a payer means going in network with them.

The enrollment process for sending claims is quick and easy for most payers. There is a new streamlined process built into TherapyNotes to take these steps. This is significantly easier than what was required with Change Healthcare.

The TherapyNotes payer list has been updated to the CLAIM.MD payers and payer IDs instead of Change Healthcare's payer list. For new payer enrollments, submitted claims may initially sit in ‘Pending’ status for 72 hours to give your new enrollment request enough time to complete. This includes any claims previously queued in a ‘Pending’ status for the payer prior to starting your new enrollment.

We recognize there are still some outstanding claims that were sent to Change Healthcare or iEDI that have not moved beyond the ‘Submitted’ status. We are actively reviewing options to get these over to CLAIM.MD. In the meantime, you can manually resubmit these if desired.

For questions on the new enrollment process, contact our enrollment support team at (215) 658-4550, option 4. Please do not contact CLAIM.MD directly for enrollment support. They are not able to assist and will direct you back to our TherapyNotes Support team.

Status: We released full support for self-enrollment of claims and ERA services, including the ability to submit claims to payers that require enrollment. Please see the release notes for more information.  (Updated 4/24)

How do I enroll if my practice has multiple clinicians with their own tax ID and group NPI?

The self-enrollment feature in TherapyNotes uses the practice's tax ID and group NPI from the practice settings. If you have a practice account shared by multiple clinicians (known as co-op practices) with their own tax ID and group NPI (such as in the clinician settings billing overrides), you will need to contact our enrollment team at (215) 658-4550, option 4, to help you complete your enrollment. 

PO Box Rejections

We are seeing many rejections due to the presence of a PO box in the address. If you see this rejection reason you need to remove your PO Box from Practice Information, Multiple Practice Locations, and Clinician Billing Setting Overrides. Instead you can put a PO Box in Alternate Billing Address in Practice Billing Settings. (Updated 4/10)

Payer Specific Updates

• Advantek Benefit Administrators (83077): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (4/29)
  
• HealthPlan Services (59140): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (4/26)

• Employee Benefits Plan Administration, Inc. (03036): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (4/24)
• Passport Advantage (66008): You may have received rejections that state "DUE TO THE RECENT CYBERSECURITY INCIDENT, THERE IS NOT CURRENTLY AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER". The connection to this payer has been restored and you can resubmit these claims. (4/23)
• Indiana ProHealth Network (35161): This payer was previously not accepting claims because they were dependent on Change Healthcare. They are now accepting claims again. (4/23)
• Mississippi Physicians Care Network (64084): This payer was previously not accepting claims because they were dependent on Change Healthcare. They are now accepting claims again. (4/23)
• Looking for another payer? Here is the full payer list
  

Why aren't I getting ERAs? What happens to old ERAs I didn’t get?

TherapyNotes is now able to receive ERAs from CLAIM.MD, however, enrollment is required. In many cases, this is as simple as clicking a button. Sometimes, there is paperwork to complete, which is streamlined within TherapyNotes (No printing or faxing required). In some cases, you will be given instructions to follow on the payer’s website.

We are now also receiving ERAs from Medicare payers via Change Healthcare. The ERAs we received so far cover claims submitted months ago through claims sent as recently as this month. Keep in mind that it is irrelevant how you submitted a claim to receive an ERA. If you submitted the claim on a payer portal, by paper, through an external clearinghouse, or through us by way of any of the 3 clearinghouses we've used over the past 2 months, the claims can all be on the same ERA that we receive from Change Healthcare. Change Healthcare indicated that they are working to get Aetna ERAs to us next. 

Some payers may be agreeable to resend ERAs to you. Practices are encouraged to call payers to make this request, but not until after you are enrolled to receive ERAs from CLAIM.MD.

Status: Self-enrollment for ERAs is now available. Please see our release notes for more information.  (Update 4/24)

Can I do eligibility checks or mail paper claims?

The ability to do eligibility checks and have the clearinghouse mail paper claims are not currently available but will be brought back in the future. You can still generate your own CMS-1500 forms within TherapyNotes and mail them on your own.

Status: We have begun planning to bring these features back. (Updated 4/17)